An uncanny reason for a visit to the ER is when a playful pup manages to get one of those circular marrow bones caught around its lower jaw and canine teeth. I still remember my first patient that found himself in this very predicament; perplexed, I thought, “How is this even possible?” While it looks like a trick that only David Copperfield should be able to pull off, it can actually happen with surprising ease.

When it comes to marrow mishaps, I have seen the entire breadth of bone bad luck. While some are easily removed with lubrication and gentle manipulation alone, others need to be removed with a cast cutting saw (or other manly tool, depending on the thickness of the bone) while the pet is sedated. I have also seen dogs that have suffered from fractured canine teeth as well as extensive injury to their lower jaw and tongue. Tissue injury occurs when the circulation of blood is cut off to the skin and/or tongue while it is trapped within the bone. The marrow bone literally turns into a tourniquet with the continued and inevitable swelling of the tissues. Major or minor, any of these situations can be painful, distressing, and potentially very costly, depending on the extent of trauma and demeanor of your pet.

Your dog absolutely loves these bones and you love to give them, so what’s a pet parent to do? Here are a few tips to help prevent any misadventures:

Size really does matter. Make sure the size of the marrow bone is suitable for the size of your pet. Have your butcher “custom make” your marrow bones, trimming them into longer pieces, such as 8 inches for larger dogs. Skinnier bones can more easily work themselves around the jaw, and should be avoided.

Try a knuckle bone instead. These can offer a similar chewing experience, and because there’s no hole, there is no risk of it slipping around the jaw. However, as with any type of bone, these too, can come with risks. Be sure to take them away while they are still large, which is as soon as the gristle and soft parts of the “knuckle knobs” are gone. This will help to prevent accidental swallowing and choking once it is whittled down to a smaller size.

Sensitive stomach? Marrow bones may not be the chew of choice for those pets that get diarrhea or an upset stomach easily. Marrow is very high in fat, and I have seen them cause these signs, as well as pancreatitis, in pets that are not used to the richness of the marrow fat.

Lastly, never leave your dog unattended while he or she is fancying the flavor—it is amazing how fast these accidents happen! And remember, extra aggressive chewers need extra close supervision.

As gratifying as these treats can be, one can still find a bone to pick with them because the serious complications happen just as often as the “simple ones.” The marrow of the story: know the risks and let your pet enjoy them only under direct supervision.

Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.